Design and initial results of the Canadian lipoprotein(a) registry
Bibliographic record
Abstract
Abstract Background Lipoprotein(a) [Lp(a)] is a genetically determined independent risk factor for atherosclerotic cardiovascular disease (ASCVD). Multiple guidelines recommend universal testing of Lp(a) once in an individual’s lifetime, and intensification of risk factor management in individuals with elevated Lp(a). However, there are limited data about how Lp(a) levels are being used in clinical practice. Purpose The Canadian Lp(a) Registry is designed to characterize the risk factors, management, and outcomes of patients with elevated Lp(a). Here we report the design and preliminary characteristics of patients enrolled in the registry. Methods The Canadian Lp(a) Registry is a prospective, longitudinal observational study including participating sites throughout Canada. Enrolment began in June 2024 and the inclusion criterion is Lp(a) ≥100 nmol/L (50 mg/dL). Data are collected at baseline and at annual follow-up, and include patient demographics, risk factors, lab values, imaging tests, medications, and cardiovascular outcomes. Results A total of 93 patients were enrolled in the registry as of February 2025, 47 (50.5%) of whom were male (Table 1). The mean age was 57.1±13.0 years. The median Lp(a) level was 225 (IQR 186-346) nmol/L. The mean number of Lp(a) measurements per patient was 2.0±1, with 48 (51.6%) having more than 1 lifetime measurement of Lp(a). Probable or definite familial hypercholesterolemia was present in 36.6%. The mean low-density lipoprotein cholesterol (LDL) was 2.31 ± 1.58, with most patients (79.6%) being on lipid-lowering therapies. These included statins (75.3%), ezetimibe (47.3%), and PCSK9 inhibitors (34.4%). Many patients (53.8%) were taking multiple lipid-lowering therapies. Cardiovascular disease at the time of enrollment in the registry included 18 (19.4%) patients with prior myocardial infarction, 31 (33.3%) with prior coronary revascularization, and 4 (4.3%) who had a previous stroke or transient ischemic attack. A history of severe aortic stenosis was present in 4 (4.3%) patients. Conclusions The Canadian Lp(a) Registry is a prospective observational study designed to generate real world evidence regarding the clinical management and cardiovascular outcomes for patients with elevated Lp(a). Preliminary results from the baseline characteristics of the registry indicate this is a high-risk population, with many patients having pre-existing ASCVD or familial hypercholesterolemia. However, 1 in 5 patients with elevated Lp(a) were not taking any lipid-lowering therapy at the time of enrolment. Repeat testing of Lp(a) levels was common and could suggest uncertainty among care providers about how to use Lp(a) testing. Future results from this registry will help improve understanding of how Lp(a) levels are being used as part of routine clinical practice and to identify opportunities to optimize the quality of care of this population.Table 1
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.018 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.007 |
| Science and technology studies | 0.005 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".